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Pneumococcal Subcutaneous Abscess in Immunocompetent Children

THOMAS E. LISTON, MD
Am J Dis Child. 1982;136(10):947-948. doi:10.1001/archpedi.1982.03970460077019.
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Skin and subcutaneous involvement is distinctly unusual when the infecting organism is Streptococcus pneumoniae. Cellulitis associated with bacteremia due to S pneumoniae has been reported in adults with drug addiction1 and macroglobulinemia2 and in children with facial cellulitis.3 From both blood and subcutaneous aspirate cultures, Fleisher et al4 isolated S pneumoniae from one of 25 children who were seen in their emergency department with cellulitis. I am aware of only one previously reported case of a subcutaneous abscess caused by this organism. In that patient, an adult who had had a splenectomy for idiopathic thrombocytopenic purpura 14 months before, blood cultures were negative but a fluctuant mass on the shoulder disclosed S pneumoniae on smear and culture.5 I report two cases of pneumococcal subcutaneous abscess in otherwise healthy children and suggest that their infections occurred as an unusual complication of occult pneumococcal bacteremia.

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